Rectus sheath haematoma: a new set of diagnostic features

Abstract

Rectus muscle haematoma is a well documented clinical entity, but its diagnosis remains elusive. A haematoma within the rectus sheath produces a painful, tender swelling that can mimic an intraperitoneal mass with features of an acute abdomen. Two patients with rectus haematomas presenting after bouts of prolonged coughing are reported. In both cases, clinical features and ultrasound findings suggested the presence of intraperitoneal pathology. However, in both cases consistent findings in the history and examination pointed towards the diagnosis of a rectus haematoma. It is proposed that these simple clinical criteria are diagnostic of a rectus sheath haematoma, and can thereby avert an unnecessary laparotomy.

Hematoma de la vaina de los rectos en un recién nacido macrosómico después de un parto distócico. A propósito de un caso

“…7,8 Hasta donde sabemos, este es el primer caso de hematoma de la vaina de los rectos en un recién nacido macrosómico. El objetivo de la presentación de este caso era destacar el hematoma de la vaina de los rectos como traumatismo obstétrico en un recién nacido macrosómico.…”

Rectus sheath hematoma in a macrosomic neonate following difficult delivery.

“…7,8 To the best of our knowlegde this is the first case of RSH in an injured macrosomic neonate. We aimed to present this case for emphasising RSH as a birth injury in a macrosomic baby.…”

Conservative management of a progressively growing rectus sheath hematoma presented in a patient with chronic renal failure: A case report

“…USG should be the device of choice because of its extreme accuracy that may reach 100% in experienced hands, in addition to its ready availability and absence of radiation exposure. It is also helpful in excluding other intraabdominal pathology and in monitoring the size of hematoma by serial examinations [15,16]. Some authors recommend a CT scan for unclear abdominal disorders, and when the extent and anatomic landmarks of the hematoma need to be identified.…”